Diagnosis: Excess Lipase

This post was written for inclusion in the WBW 2013 Blog Carnival. Our participants will be writing and sharing their stories about community support and normalizing breastfeeding all week long. Find more participating sites in the list at the bottom of this post or at the main carnival page.

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Excess lipase stinks. Literally.

Here’s my story …

After pumping and freezing over 200 ounces in preparation for my return to work I discovered I had excess lipase. It wasn’t an easy find though. The last month of my maternity leave we started offering Jemma bottles of breast milk. She hated it. We warmed it, cooled it, tried a different temperature, a dozen bottle nipples, from mom, from dad, from grandma, in a chair, while lying down, while watching Baby Einstein. We tried everything. Bottles were a no go.

I consulted my La Leche League leader (she is an angel and has seriously supported me through so much!) and she described excess lipase to me. It seemed to fit, so I tested my milk.

How I tested my milk for excess lipase …

Express a small sample of breast milk and place in the fridge – maybe 2 ounces or so

At various intervals – 2, 4, 6, 12, 18 and 24 hours test the milk by smell and taste, chart what you find

If the sample has excess lipase, you’ll notice a soapy taste and a spoiled smell at some point. Different moms with excess lipase experience “the turn” at different times. Sometimes it is immediate, sometimes it’s a few hours later.

My milk turned right around 18 hours. Anything expressed and consumed before that 18 hour mark had no taste/smell change. Anything after, was a lost cause.

So, what exactly is lipase …
According to KellyMom: Lipase is an enzyme that is normally present in human milk and has several known beneficial functions:

Lipases help keep milk fat well-mixed (emulsified) with the “whey” portion of the milk, and also keep the fat globules small so that they are easily digestible (Lawrence & Lawrence, p. 156).

Lipases also help to break down fats in the milk, so that fat soluble nutrients (vitamins A & D, for example) and free fatty acids (which help to protect baby from illness) are easily available to baby (Lawrence & Lawrence, p. 156).

The primary lipase in human milk, bile salt-stimulated lipase (BSSL), “has been found to be the major factor inactivating protozoans” (Lawrence & Lawrence, p. 203).

So, when there is excess, the lipase enzyme works in overdrive and results in the sour smell and odd taste.

How to “fix” milk effected by excess lipase …
Sadly, expressed milk that has turned can’t be salvaged. But, freshly expressed breast milk can be treated before it is stored. To “fix” excess lipase expressed milk can be stored by scalding the milk. It’s best to do this as soon as possible. By scalding, the lipase is made inactive and stops the process of fat digestion.

To scald milk …
Transfer breast milk into a glass bottle and place into a bottle warmer. Insert a digital thermometer and turn on. This thermometer is my favorite because you can set your desired high temp and it beeps when it reaches that temperature. The goal for scalding is to reach 180 degrees.

Once scalded, quickly remove the bottle from the bottle warmer and cool. I found it easiest to quickly pour the heated milk into a new glass container and place in the fridge. An ice bath is also an option. Just be sure that the hot glass doesn’t get quickly cooled or else it will shatter.

When no longer warm, milk can be poured into storage bags and frozen “like normal”.

A side note from KellyMom … “Scalding the milk will destroy some of the anti-infective properties of the milk and may lower some nutrient levels, but this is not likely to be an issue unless all of the milk that baby is receiving has been heat-treated.”

The rest of the story …
Once I determined I had excess lipase I mourned my freezer stash of pumped milk that was effected. But then I got to work setting up my scalding routine. Every day when I got home from work, my husband would start scalding that days pumped milk while I nursed my daughter. It became second nature to scald milk and although an annoyance, when it comes to breastfeeding struggles, I’ll take it.

Excess lipase is rare. I’ve yet to meet another mama in person who has battled it. But, the internet is a wonderful place and through it I found invaluable research, resources and friends.

If you would like an extensive review of lipase and how to cope I highly recommend a fellow excess lipase mama’s ebook, Why Does My Breastmilk Taste Bad?. Worth every penny!

Please take time to read the submissions by the other carnival participants. Below are a list of links for today’s participants; you can find a complete list of links (updated throughout the week) at our main carnival page:

(This list will be updated by afternoon August 3 with all the carnival links.)

Breastfeeding and NIP: A Primer — Rachel Rainbolt of Sage Parenting, featured today at NursingFreedom.org, uses her informative and candid voice to share with you everything you need to know to breastfeed successfully in public, from the practical how-to’s to handling the social stigma.

Lactivist Ryan Gosling — Breastfeeding mamas, the time is long overdue for a Lactivist Ryan Gosling. Fortunately, Dionna of Code Name: Mama has created some for your viewing pleasure.

In Defense of Formula — Amy of Mom2Mom KMC, guest blogging for Breastfeeding in Combat Boots, asserts that formula is a medical tool rather than a food. She examines how this perspective supports breastfeeding as normal and eliminates the negative tensions between breastfeeding and non-breastfeeding mothers.

Nursing in the Wild — Meredith at Thank You Ma’am posts about how seeing other moms nurse can make all of us more comfortable with nursing in public.

Normalizing Breastfeeding — Sara Stepford of The Stepford Sisters confronts the social stigma vs. the reality of breastfeeding and opens up about the steps she takes to make herself and others more comfortable with the process.

Perfectly Normal — Stephanie from Urban Hippie writes about the way she and her family have done their part to try and normalize breastfeeding in a society that doesn’t get to see breastfeeding as often as they should.

Diagnosis: Excess Lipase — Learn about excess lipase and how to test if your expressed milk has it. That Mama Gretchen shares her own experience.

Redefining Normal — Diana at Munchkin’s Mommy reflects on how we can normalize breastfeeding in our society.

Nursing Openly and Honestly — Amy W. at Me, Mothering, and Making it All Work feels that the most socially responsible thing she can do as a mother is to nurse and nurture her children openly, honestly, and with pride.

Tackling Mastitis with an Older Nursling — Much of the advice available for supporting recovery from mastitis seems to be aimed at mamas with younger nurslings. Juliet of Twisting Vines, posting at Natural Parents Network shares tips for dealing with mastitis while breastfeeding a toddler.

Milk in the eye — Gena from Nutrition Basics discusses how breastmilk cured her 3 year old’s case of pink eye.

My Top Five Breastfeeding Tips for Delivery Day: Think “A-B-C-D-E” — Mothernova shares how her continued success at breastfeeding with her second child rests on a foundation of five key things she did to prepare for baby’s arrival, along with things she did when she and baby first met. Easily enough, these tips can be categorized as “A-B-C-D-E”: Access to lactation consultant, Baby-friendly hospital, Communicate your plan to breastfeed exclusively, Demand, and Expect to room in.

Breastfeeding on a Dairy-Free Diet: Our Journey and Our Tips — Finding herself nursing a baby with food allergies, Jenny at Spinning Jenny embarked upon a dairy-free journey with her son for eight months. Here she relates her reasons for making the decision to give up dairy in her diet, why it was worth it, and tips for moms on the same path.

Normalizing Breastfeeding in my Home — Shannah at The Touch of Life shares how she plans to help keep breastfeeding normal for her own children, even when her breastfeeding years are over.

A Year With My Nursling — The more you see and hear, the more normal it becomes, so That Mama Gretchen is sharing her heart on the last year of breastfeeding – the ups and downs, but mostly the joy of her priceless relationship with her son.

From Covered to Confident — Krystyna at Sweet Pea Births shares her personal NIP evolution: she started by covering up from neck to ankle while nursing in public. Eight years later, she has gained confidence and the ability to nurse without stressing about flashing a little skin. She shares her views on normalizing breastfeeding – what influenced her and how she hopes to help others.

Normalizing Breastfeeding for Older Kids — Sadia at How Do You Do It? hopes that openly discussing breastfeeding with her (now weaned) daughters will help her children feel comfortable with breastfeeding and their bodies in general as they grow.

Nursing in Public — Listen up, mammas. Those other people around . . . they don’t matter. It’s not about them. It’s about you and that beautiful baby. Nurse on, says The Swaddled Sprout!

How to Nurse a Teenager — Sarah at The Touch of Life declares: the purpose is to help normalize breastfeeding a toddler.

After Jemma associated bottles with yucky milk we ended up cup feeding. Started that a 4 months and that’s all she did while I was away at work. She reverse cycled too. So, although not conventional … we made working/pumping/breastfeeding work for quite a while!

I had a friend whose milk "wouldn't keep." This is going in my toolbox of breastfeeding advice. Thank you so much for sharing!! This friend was one who supported me through the hardest parts of nursing, because she got it!

You know that I may never have thank you then – but when you wrote about this the first time we could not figure out why my daughter refused my frozen milk. Then I really smelled it and tasted it – and I totally understood. It was disgusting by 12 hours. SO though we have never met – I had the same problem and you really helped. Thanks Gretchen.

You know that I may never have thank you then – but when you wrote about this the first time we could not figure out why my daughter refused my frozen milk. Then I really smelled it and tasted it – and I totally understood. It was disgusting by 12 hours. SO though we have never met – I had the same problem and you really helped. Thanks Gretchen.

My friend had this problem with her milk – like you, she has never met anyone else in person with the same challenge. Thank you for posting this as a resource. A situation like this is so much more manageable when you know you are not alone. (From Krystyna @SweetPeaBIrths)

My friend had this problem with her milk – like you, she has never met anyone else in person with the same challenge. Thank you for posting this as a resource. A situation like this is so much more manageable when you know you are not alone. (From Krystyna @SweetPeaBIrths)

After Jemma associated bottles with yucky milk we ended up cup feeding. Started that a 4 months and that's all she did while I was away at work. She reverse cycled too. So, although not conventional … we made working/pumping/breastfeeding work for quite a while!

Thanks for sharing this information! I’ve been scalding my milk on the stove top but need to buy a bottle warmer because I will be going back to work soon. Can you tell me which specific bottle warmer you used? Thanks!

I’m looking online and not finding the one I have … it must be an older model. It’s just a normal bottle warmer, nothing fancy. What I did get that was “fancy” was a digital thermometer with a beeper. I found it at Target. I could set the temperature to 160 and then it would beep when it hit that temp so I wouldn’t have to stand right next to it as the milk heated. Hope that helps!

Just wanted to say thank you for this article. I return to work in 2 weeks and am in the same panicked state. I have 100+ ounces of frozen breast milk that I recently discovered is “bad” due to high lipase. My son won’t take any of it! It’s truly devastating. I am grateful to have this resource available online to learn how to quickly get some more milk scalded and stored in time to return to work.

I’m so glad you found it to be helpful! All the best in your transition back to work, and definitely pursue donating your high lipase milk to a milk bank! They make it soooo simple either by sending you an overnight cooler (they pay shipping) or, if you’re near a big city, perhaps a local drop off site. All the best sweet mama!

Thank you for this article! I just discovered why our little one had been rejecting bottles too – the milk tastes bad!! So, I will be pumping at work every 3 hours. Will I need to scald the expressed milk immediately or can I wait until I get home?

Everyone is different. My milk didn’t “turn” until about 18 hours. So, I’d recommend pumping on a day you are home and putting an ounce or so in the fridge. Every hour test it – by smell and taste. You’ll know when it turns and that will give you your hour mark that you need to scald by. Best of luck! It’s frustrating and obviously not what any of us plan, but you’ll get into a good routine and eventually not think anything of it! Hugs!

Hi, just wondering how long you were about to keep the milk in the freezer after scalding? I just discovered my stash of 200oz is bad. So devastated and wondering if it’s even worth pumping and freezing if it not last. Thanks!

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